Abstract

Objective: The aim of the current prospective study was to analyse the validity of MRI based diagnosis of brainstem gliomas which was verified by stereotactic biopsy and follow-up evaluation as well as to assess prognostic factors and risk profile.

Methods: Between 1998 and 2007 all consecutive adult patients with radiologically suspected brainstem glioma were included. The MRI-based diagnosis of the lesions was made independently by an experienced neuroradiologist. Histopathological evaluation was performed in all patients from paraffin embedded specimen obtained by multi-modal image guided stereotactic serial biopsy technique. Histopathological results were compared with prior radiological assessment. Length of survival was estimated with the Kaplan Meier method and prognostic factors were calculated using the Cox model.

Conclusion: Intra-axial brainstem lesions with radiological pattern of glioma represent a very heterogeneous tumour group with completely different outcome. Radiological features alone are not reliable for diagnostic classification. Stereotactic biopsy is a safe method to obtain a valid tissue diagnosis, which is indispensible for treatment decision.

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